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PHTH 544 -Neuro > POSTURAL CONTROL > Flashcards

POSTURAL CONTROL Flashcards

1
Q

All mobility tasks share in common what 3 essential task requirements

A
  1. Progression = motion in a desired direction
  2. Stability = postural control
  3. Adaptation = ability to adapt to a changing task and environmental conditions
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2
Q

The neural regulation of tone contributes to anticipatory and reactive postural control based on what

A

previous experiences and learning

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3
Q

What leads to the activation of postural muscles in mobility

A

Support given during the task and the initial posture

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4
Q

Preparedness for the task results in….

A

a shortening of the onset time for both postural and prime mover muscles

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5
Q

Can mental imagery help prime the system

A

yes.. q

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6
Q

From what systems does CNS gain important information about postural control and balance

A
  • Vision
  • Somatosensory
  • Vestibular
  • CNS integrate this and initiates goal-directed conscious actions and automatic unconscious adjustments to posture and movement
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7
Q

What input dominates on a firm surface

A

somatosensory

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8
Q

On an unstable surface what system inputs the most

A

vestibular

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9
Q

What is Limits of Stability

A

Max distance an individual is able or willing to lean in any direction without loss of balance or changing BOS

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10
Q

What influences limits of stabiilty

A

Height, foot length for A/P direction, as well as COM position and movement

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11
Q

What is postural sway

A

Postural shifts to maintain balance

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12
Q

What Postural sway strategy is used for small perturbations on firm surfaces

A

ankle

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13
Q

What postural sway strategy is used with large perturbations or if support surface is narrow and smaller than feet

A

hip strategy

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14
Q

When is stepping strategy used

A

when a postural perturbation is strong enough to displace the COM out the BOS of the feet -forced to take step to bring COM into BOS

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15
Q

What occurs to sway in elderly

A

Sway is increased during quiet stance in the ant/post and med/lat position

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16
Q

What are the reactive control alterations in elderly

A
  • Slower onset time post perturbation
  • Increased co-activation (co-contraction)
  • Tend to use hip strategy more than young adults
17
Q

Explanation for altered reactive control in the elderly?

A
  • Delay in central processing time
  • Slower nerve conduction in afferent/efferent pathways
  • Muscle weakness (ankle>hip)
  • Decreased muscle ROM
18
Q

Changes in postural control post stroke

A
  • Increased sway in standing
  • Typically presents with hesitancy to shift weight towards weak side
  • Delayed postural responses with perturbation
  • Loss of postural muscle activation during voluntary movements
  • Inability to adjust to changing task demands
19
Q

Are stroke patients aware of their deficits in balance?

A

yes normally

20
Q

What is pusher syndrome

A

When person with one sided damage to brain pushes self over to weaker side due to perceptual deficits/alignment deficits

21
Q

Is incidence of falls higher among PD patients

A

yes - more than 1/3 of patients with PD experience fall s

22
Q

What are observed postural changes in individuals with PD

A
  • increased medial lateral postural sway in quiet standing
  • Altered anticipatory control
  • Altered reactive control (particularly in LE perturbations)
23
Q

assessment tools/outcome measures for postural control/balance

A
  • berg balance scale
  • Community balance and mobility scale
  • Functional reach test
  • TUG
  • BESTest and Mini BESTest
  • Dynamic Gait index
  • Function is sitting test
24
Q

What does BEST stand for in BESTest

A

Balance evaluations systems test

25
Q

7 domains of balance in the BESTest

A
  • Biomechanical constraints
  • Stability limits/ verticality
  • Anticipatory
  • Postural responses
  • Sensory orientation
  • Stability in gait
26
Q

What is the Goal of the BESTest

A

to diagnose which balance system is affected and develop Rx plans to intervene on the balance system

27
Q

Does training one balance domain help with the other domains

A

no

28
Q

What are the domains on the mini BESTest

A
  • Anticipatory
  • Postural responses
  • Sensory orientation
  • stability in gait
29
Q

What are some contributory factors to fall

A
  • Smaller limits of stability
  • with age + neurological injuries you may get abnormal representations of limits of stability, leading to postural instability
  • The use of stepping/leaning strategies more than ankle strategy which is correlated with increase risk of falls
30
Q

What is the goal for treatment for postural control

A

To increase trunk activation/motor control/client’s ability to maintain upright

PHTH 544 -Neuro (5 decks)

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